Attention Deficit Disorder

WHAT IS ADD? DIAGNOSING ADD WHAT ADD Is NOT WHAT'S IN A NAME? HOW THE ADD MIND WORKS RESULTS OF ANALOG VS. DIGITAL THINKING TYPES OF ADD

TYPES OF ADD

Those of us who are ADD do not make up one homogenous group, although we do share many common attributes. Over the years I've noticed three main types of ADD: Outwardly Expressed ADD, Inwardly Directed ADD, and Highly Structured ADD. Each of these three has strengths and weaknesses in terms of surviving and functioning effectively in the world as it is. Each displays com¬monly identified ADD traits in different ways. Identifying which form of ADD a person has makes it easier for me to figure out what that person needs-and why someone does what he does in the way that he does it.

Outwardly Expressed ADD
Candice is a super saleswoman. Artistically talented, she constantly comes up with new products and ideas. Her enthusiasm for anything new inspires her cus¬tomers. And, usually, her ideas are good. For example, when she was designing a marketing campaign for a local politician, she completely turned his image around from a quiet egghead who was out of touch with his constituency, to a sensitive person who cared about the people he wanted to serve and had solid plans for helping them meet their needs. She got straight A's as an image shaper.

Later Candice started her own mobile pet-grooming business. Up until then, people in her area had to take their pets across town in inclement weather with children in tow or at inconvenient hours. When she couldn't manage to get her pet groomed at her convenience, she noticed a need for a mobile service. So Candice dropped other projects she was bored with, bought a van, had it redesigned inside and went into business. People loved her idea, and it definite¬ly met a need in the community.

Unfortunately, however, Candice was out of business in a year because she couldn't manage the scheduling or keep track of her records. Her idea was great. But her management left a lot to be desired.

Over the years Candice has held many jobs, sometimes working in sales for a company and sometimes starting her own business. Although she prefers self¬employment, she has often had to return to working for someone else because, when she was left on her own, her businesses tended to get off track as her paper¬work and planning didn't get done.

She also had a problem with her temper. Coworkers knew not to cross Candice, who is really a cream puff at heart. But with little patience for office politics, Candice wasn't immune from telling off the boss, or anyone else for that matter. Now in her early forties, Candice has her temper fairly well under con¬trol-at work at least. She figures she's lost out too many times because of impa¬tience and impulsivity and is trying very hard to keep her mouth in check.
Candice is typical of one type of person who is ADD. Very creative, outgoing and overachieving, she is spontaneous and able to "go in for the kill" with impec¬cable timing when a deal needs to be closed. But that same high level of sensi¬tivity and intuition that lets her quickly and accurately assess business situations also causes her to suffer hurt when she is around a painful situation or person who is critical, blunt, or abusive.

Candice has Outwardly Expressed ADD. I call people with that type of ADD the Active Entertainer. Many successful people in show business, public rela¬tions, sales, and any high-risk business are wired in this way. Anyone can see everything they are doing or thinking or feeling. It's all out there for the world to view. Good of heart, this type of person leaves little to the imagination. However, quick reactions also mean a tendency to job hop and not stay in relationships for very long. Living in terror of getting bored, people with Outwardly Expressed ADD are often seen stirring things up.
When someone with this type of ADD utilizes her innate talents and gifts, she is likely to be highly successful in life. If you are wired this way, you may already be using your ADD to advantage. If, however, you haven't yet discovered your identity and your innate talents and gifts, it is likely that you have gotten into a fair amount of trouble-possibly including getting fired or even ending up in jail- for acting impulsively and being disruptive, especially if drugs or alcohol are involved. No one will doubt your level of frustration, but neither will society feel sorry enough for you to tolerate your inadequacies.

If you are a person with Outwardly Expressed ADD, you might be more con¬cerned with getting a job done than with spending the time it takes to do a qual¬ity job. When you are confronted with your own slap-dash job, you may be inclined to blame the other guy rather than reassessing what you might have done better.

People with Outwardly Expressed ADD tend to be extremely active, both physically and verbally. They feel severely confined when asked to stay seated, sit still or walk at a leisurely pace. If you have this type of ADD, you are probably very familiar with the feeling of wanting to get on with the show and not stay in one place too long. If you can channel your activity level properly, you can real¬ly accomplish a lot. If not, your activity level can get you into a lot of trouble. You'll have to decide for yourself which way to go on this one.

If you have Outwardly Expressed ADD, your emotions ride the waves from crest to trough depending upon what is happening in your life at a given moment. With lots of childlike innocence you may reign eternally hopeful even in the presence of a sinking ship. Then when, to your surprise, the ship sinks, you are devastated, not having seen it coming.
I understand what you are going through because I have a lot of this type of ADD to contend with. I love it- but it does cause me trouble at times.

Inwardly Directed ADD
Matthew tinkers. He builds all kinds of things - inventions for easier living, foun¬tains and houses for birds and people-and he dreams. Since he was a little boy, Matthew could be seen staring off into space. When asked what he was doing, he'd reply, "Thinking." Then the next day he'd arrive with something that he'd drawn or made. One time it was a small broom made out of pine boughs that he'd constructed to sweep a friend's fireplace. Another time he sketched a design for a go-cart that eventually won a prize in a school contest.

Though he didn't always finish his schoolwork, Matthew did manage to com¬plete high school. He chose not to go to college, however, although he certainly had the intelligence for it. He felt "formal" education got in the way of his learn¬ing. He knew what he wanted to learn, and he knew how to find any information he needed.

Matthew could look at a building project or problem and immediately see the whole picture. He would then begin to play with ideas for solving the problem. He called it "puttering around" in his mind. Sometimes he would then tinker with various ways to produce a prototype to solve a problem. People who didn't understand how Matthew's mind worked would try to get him to make a plan or an outline. When he was young, that frustrated him. Now he knows that's just a waste of time for him.

For a long time, though, Matthew's frustration fed his feelings of inadequacy. He became quite depressed as a young adult and felt like a failure as he watched his classmates take off in their careers. He even blamed himself for not trying harder.

Depressed, trying many different ways to make a living by doing whatever came along, Matthew had little time for any social life. Although he didn't mind that a lot because he was fairly shy, he did like company. He had one friend, though, who liked to "mess around" with wood, repairing used furniture and building anything he thought he could sell.

The two spent many evenings together, not saying much but enjoying keeping each other company while working on their individual projects. Matthew told his friend about his ideas for building homes using wood and stone. He figured he might never have an opportunity to do the building he wanted to do, but his dream wouldn't go away.

Then one day, the father of his "messing around" friend asked him ifhe would please take charge of building a house-one the man had in his mind. He had¬n't been able to find anyone who could capture his dream. But after listening to his son talk, he had a hunch that Matthew might be the very person he was look¬ing for.

Matthew not only captured this man's dream in wood and stone but did it in an economical and timely manner. Finally, Matthew began to realize that he wasn't so inadequate after all. He was on his way to a career that fit him.

The main hitch that Matthew ran into was keeping track of his business-the records, pieces of paper, and money. He also became restless from time to time if the house he was building didn't tax his creative talents. Boredom, which came from doing something he already knew how to do, conflicted with his desire to make a substantial living. This became even more stressful after he met a woman he thought he could settle down with. He vacillated between taking on the responsibility of being a married man and being free to accept only those jobs that he really wanted to do.
When Matthew couldn't make up his mind about getting married, his girl¬friend became anxious and began to nag him. Soon their relationship soured, but Matthew seemed unable to let go of it. Finally she handed him an ultimatum which he didn't answer. She left, taking his silence for a "no."

Matthew has Inwardly Directed ADD. He is what I call a Restless Dreamer.

Many people who are artists, artisans, craftsmen, and inventors are wired with this form of ADD. The old-fashioned engineer who can jury-rig anything, the mechanics, builders, and technical people of the world, often fit into this cate¬gory. Many people who enjoy working outdoors, or with plants and animals, have Inwardly Directed ADD. Finally, many people drawn to service-oriented jobs that make use of empathy and sensitivity, including teachers and counselors, are using the talents that came with their Inwardly Directed ADD.

It's often hard to tell what someone with Inwardly Directed ADD is thinking because talking may not be their forte. But you often find this type of person com¬municating through their work. A glance will acknowledge that what one person is doing is appreciated by another. Subtle social cues are often missed by their less sensitive coworkers. But don't ever underestimate the quiet dreamer who sees a whole lot more than is communicated openly.

If you are wired in this way, your biggest problem may be depression.

"Stuffing" your feelings, rather than getting them out, won't give you a chance to express anger, frustration, and helplessness. You need to realize that glitz and dog-and-pony-shows aren't the only ways to success. It could be that your quieter way is just fine. But you do need to stand up for yourself and your way of doing things. Just as Matthew finally learned that his way was okay, you, too, must come to believe in yourself-even in the face of another's rejection.
You are likely to stay too long in any given situation, job or personal, whereas your counterpart with Outwardly Expressed ADD tends to not stay long enough. Indecision, procrastination, and "dreaming around" can block you from moving toward implementing your dreams. A lot of these reactions, however, result from your not believing in yourself-your talents, unique ways of doing things, and your dreams.

Though you are not hyperactive physically, and certainly not hyperverbal, you probably hate being tied to a desk. Restless is a good word to describe what you feel. You may rarely be still. But even your movement is probably subtle as you shift weight and walk around quietly.

Ultimately, pessimism can get you down, so you will need to make a real effort to look on the bright side of things. With the dreams you hold inside, all you need to add is belief in yourself, and you can become the winner you were always meant to be. Don't stop dreaming. Teaming up with someone who can sell your dreams may be just the solution you've been looking for. Keep your eyes open!

Highly Structured ADD
Gwen has her own company. She has found her fit in the age of computer tech¬nology. She organizes everything in her life by using her computer, so much so that a scrap of paper rarely crosses her desk. E-mail has replaced letters and even faxes. Computer bulletin boards often bring her together with the people she needs to spend time with in business and allow her to get answers at a moment's notice. The Internet has become her main marketing tool.

Throughout school Gwen was the perfect student. She didn't mind doing homework, as long as the assignment was clear. The only time she really had trouble was when her science teacher told her to brainstorm for a week and then develop a science project, any project she liked. Gwen didn't have any idea where to start her thinking, and she panicked. She told her teacher that the assignment was stupid and that it needed to be redefined.

The teacher took mercy on Gwen and gave her two projects to choose from, along with a set of guidelines for proceeding. Within this structure-with a small, fixed number of variables-Gwen was able to be comfortable and creative.

As an adult Gwen's hobbies include quilting and folk painting, both of which are highly structured activities. Her house is orderly and she becomes upset when company comes and leaves a path of chaos behind. It takes her a long time to get things back in order. She doesn't understand why people can't do one thing at a time and put things back where they got them when finished.

Gwen is not an unkind person. She just hates disorder. It makes her feel bad, even frightens her because she doesn't have a clear picture in her mind of how to regain control of the situation and restore order. She has a hard time creating a structure for herself.
Her friends call her a perfectionist, and she supposes she is. She wishes every¬one would be that way. Life would be a lot simpler then. This need almost cost her a marriage when she tried to apply her values and principles to her husband, a fairly laid-back person. And it's a good thing he was relaxed, or he probably would have left the marriage. He did almost walk out when Gwen's need for con¬trol took a scolding form. He didn't mind if she wanted things highly organized, but he did mind when she started to take over his life and talk down to him.

Gwen discovered that they each had to have areas in which to take responsi¬bility and have supreme control. That way, they could each handle their own affairs the way they wanted to in their specific area and leave the other person alone. Gwen, who loved her husband and didn't want to lose him, realized she had to go along with this plan.

Gwen has Highly Structured ADD. She is the kind of person I call a Conscientious Controller. Many people in the military, who do accounting and financial planning, or who pilot aircraft or perform intricate, delicate procedures fall into this category. Any job requiring extreme attention to detail and precision serves as a comfort for the Conscientious Controller.

If you have Highly Structured ADD, you typically appear to be very controlling. But that's not because you're a bad person. Rather your problem lies in not being able to create a structure easily. Once a structure is in place, you need to hold tight to it, which includes expecting others around you to do the same.

As one man I knew explained it, "No sooner do I get everything in place than someone or something changes one aspect of it, and everything is destroyed. There I sit in a pile of rubble so that I have to rebuild the whole thing all over again, piece by piece. And that takes a very long time, a lot of strenuous energy, and a lot of worrying that I won't get it right.

Often feeling overwhelmed, people with Highly Structured ADD are likely to be fairly rigid in their thinking, have quick tempers and worry obsessively. As the person with Highly Structured ADD tries to regain control, he tends to find fault with others. His mind is telling him, "If only I can lay the blame on someone else, then I might have a chance to regain my equilibrium."

This type of person obviously has trouble cooperating with others. egotiation is not easy for him. And, I promise you, with this type of person around, there can only be one boss.

The more unstructured the coworker, the more anxious, frustrated, and judg¬mental the person with Highly Structured ADD becomes. Brainstorming, free¬wheeling creativity, and trial-and-error ventures make this person nuts. Even in his creative ventures, the creativity will follow a definite, controlled plan or proven formula.

Communication is a problem for this type of person because he has trouble listening. He is so fearful of not being heard that he tends to say the same thing over and over again, and his excessive talking at another person leaves no room to determine the effect of what is being said. Some of this repetition is related to the biochemistry of the person's brain. It is difficult for this type of person to change gears from one activity to another-including changing from speaker to listener. Being a listener also requires constant adjustment to what the next response will be. That's hard if you're Highly Structured ADD.

If, however, you want a job done to perfection, the over-organization of the Conscientious Controller may just be an asset. Certainly in life-threatening situ¬ations or whenever a great deal is at stake, over-organization, control, and hyper¬focusing are an asset. If you are able to sit at a computer screen intently focusing on a program, you may just be the first one to solve a difficult problem. And you can always sleep the next day.

Hypoactivity, also an attribute of ADD, is most likely to show up in this type of person. Thus a steady hand may repair watches, stay within the lines demand¬ed of stylized painting, or keep the straight lines and tiny stitches necessary for intricate quilting.

Combined Forms of ADD
The faces of ADD do indeed look different on the surface from one form of ADD to the next. But underneath, each person has some type of compromise to the same brain center. Just as a frenetic weasel anxiously scurries about, a cat may sit transfixed, watching the opening of a mouse hole for the appearance of the prize he seeks. You won't be fooled by external appearances if you realize that under¬neath the surface lies a maze of complicated, yet, in some ways, incredibly sim¬ple, brain neurochemistry that dictates the appearance of assets and liabilities.

You may see aspects of yourself in one, two, or all three forms of ADD. Any combination is possible.

For example, Monte has a combination of Highly Structured and Outwardly Expressed ADD. An emergency-room physician, he studied obsessively at med¬ical school, and took top honors. As long as he knows what is expected of him, he's in fine form. The tight structure of the medical school curriculum made him feel confident.

When Monte first left the confines of schoolwork, though, he felt insecure until he learned procedures he could count on time after time after time. He made copious notes and preferred situations in which clear-cut guidelines were present for him to follow.

Because he also has an outgoing, high-risk-taking aspect to him, he found he was especially attracted to emergency room medicine. He loved the excitement, and his flamboyance made him a good leader of a team where the sequence of lifesaving duties was clear cut. His thinking became extremely clear in these sit¬uations, and he was able to work nonstop until the patient was out of danger.

Monte knew himself well enough to know that he could never go into anes¬thesiology or dermatology, which would confine him, trapping his hyperactive body. He also knew that he needed the absolute line of control offered by a triage team where he could be in charge. A perfectionist, he used his ADD profitably.

As you can see, each category of ADD, and every possible combination of those forms, has assets and liabilities. The bottom line is that you need to find out how your ADD manifests itself so you can find your fit-so you can discover your strengths and talents and determine how to best use them. When you've accom¬plished that, you've set yourself up to be a winner.

ADD is as good as it is bad, as easy as it is difficult. Just as a non-ADD person must face liabilities because he is non-ADD, you can compensate for your down sides and make good use of your strengths. Teaming with others who are differ¬ent from you, as you mutually respect one another's abilities, will make a whole that can make a difference for everyone involved.